氨甲环酸在老年股骨颈骨折全髋关节置换术中的临床应用
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摘要
目的:研究氨甲环酸在高龄老年股骨颈骨折关节置换中的治疗效果。方法:髋关节置换患者60例,采用随机方法分为:治疗组30例,术前1 h应用20 mg/kg静脉滴注;对照组30例,术前给予等量的生理盐水滴注。将术前和术后的失血量、输血率和术后引流量进行记录总结。结果:在输血率方面,对照组和治疗组输血率具差异有统计学意义。结论:对于降低高龄股骨颈骨折的围手术期失血量而言,氨甲环酸有较好作用,可降低输血率,宜在临床中推广应用。
Objective: To determine the effect of Tranexamic acid in total hip replacement for elderly patients with femoral neck fracture. Methods: Sixty patients,who were scheduled for hip replacement,were randomly divided into two groups. The study group( n = 30) was given 20 mg/kg Tranexamic acid by intravenous drip at 1 h before the operation. The control group( n = 30) was given equal volume of normal saline by intravenous drip before the operation. The blood loss volume,blood transfusion rate and drainage volume before and after the operation were recorded and summarized. Results: There was statistical difference in the blood transfusion rate between the control group and study group. Conclusion: Tranexamic acid is significantly effective in reducing perioperative blood loss volume and blood transfusion rate for elderly patients with femoral neck fracture,which is worthwhile of widespread use in the clinical practices.
Objective: To determine the effect of Tranexamic acid in total hip replacement for elderly patients with femoral neck fracture. Methods: Sixty patients,who were scheduled for hip replacement,were randomly divided into two groups. The study group( n = 30) was given 20 mg/kg Tranexamic acid by intravenous drip at 1 h before the operation. The control group( n = 30) was given equal volume of normal saline by intravenous drip before the operation. The blood loss volume,blood transfusion rate and drainage volume before and after the operation were recorded and summarized. Results: There was statistical difference in the blood transfusion rate between the control group and study group. Conclusion: Tranexamic acid is significantly effective in reducing perioperative blood loss volume and blood transfusion rate for elderly patients with femoral neck fracture,which is worthwhile of widespread use in the clinical practices.
引文
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[12] Shi H,Ou Y,Jiang D,Quan Z,Zhao Z,Zhu Y.Tranexamic acid reduces perioperative blood loss of posterior lumbar surgery for stenosis or spondylolis-thesis:a randomized trial. Medicine(Baltimore),2017,96(1):e5718.
[13]Yu CC,Gao WJ,Yang JS,et al. Can tranexamic acid reduce blood loss in cervical laminectomy with lateral mass screw xation and bone grafting:a retrospective observational study. Medicine(Baltimore),2017,96(5):e6043.
[14]Hallstrom B,Singal B,Cowen ME,Roberts KC,Hughes RE. The Michigan experience with safety and effectiveness of tranexamic acid use in hip and knee arthroplasty. J Bone Joint Surg Am,2016,98(19):1646.
[15] Blumberg N,Kirkley SA,Heal JM. A cost analysis of autologous and allogeneic transfusions in hip-replacement surgery. Am J Surg,1996,171:324.
[16]Gilbody J,Dhotar HS,Perruccio AV,Davey JR. Topical tranexamic acid reduces transfusion rates in total hip and knee arthroplasty. J Arthroplasty,2014,29:681.
[2]Ponnusamy KE,Kim TJ,Khanuja HS. Perioperative Blood Transfusions in Orthopaedic Surgery. J Bone Joint Surg Am Vol,2014,96(21):1836.
[3] Okamoto S,Hijikataokunomiya A,Wanaka K,et al.Enzyme-controlling medicines:introduction. Semin Thromb Hemost,1997,23(6):493-501.
[4] Irisson E,Hémon Y,Pauly V,et al. Tranexamic acid reduces blood loss and financial cost in primary total hip and knee replacement surgery. Orthop Traumatol Surg Res Otsr,2012; 98(5):477-83.
[5] WHO. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. WHO/NMH/NHD/MNM/11. 1. http://www. who. int/vmnis/indicators/haemoglobin.pdf. Accessed on 15/04/2018.
[6]Mu oz M,Acheson AG,Auerbach M,et al. International consensus statement on the peri-operative management of anaemia and iron deficiency. Anaesthesia,2017,72:233-247.
[7] Munoz M,Gómez-Ramírez S,Besser M,et al. Current misconceptions in diagnosis and management of iron deficiency. Blood Transfus,2017,15:422-437
[8]Munoz M,Laso-Morales MJ,Gómez-Ramírez S,et al. Preoperative haemoglobin levels and iron status in a large multicentre cohort of patients undergoing major elective surgery. Anaesthesia,2017,72:826-834
[9] Guler N, Burleson A, Syed D, et al. Fibrinolytic dysregulation in total joint arthroplasty patients:potential clinical implications. Clin Appl Thromb Hemost,2016,22:372-376.
[10]Melvin JS,Stryker LS,Sierra RJ. Tranexamic acid in hip and knee arthroplasty. J Am Acad Orthop Surg,2015,23:732-40.
[11]Evangelista PJ,Aversano MW,Koli E,et al. Effect of tranexamic acid on transfusion rates following total joint arthroplasty:a cost and comparative effectiveness analysis.Orthop Clin North Am,2017,48(2):109.
[12] Shi H,Ou Y,Jiang D,Quan Z,Zhao Z,Zhu Y.Tranexamic acid reduces perioperative blood loss of posterior lumbar surgery for stenosis or spondylolis-thesis:a randomized trial. Medicine(Baltimore),2017,96(1):e5718.
[13]Yu CC,Gao WJ,Yang JS,et al. Can tranexamic acid reduce blood loss in cervical laminectomy with lateral mass screw xation and bone grafting:a retrospective observational study. Medicine(Baltimore),2017,96(5):e6043.
[14]Hallstrom B,Singal B,Cowen ME,Roberts KC,Hughes RE. The Michigan experience with safety and effectiveness of tranexamic acid use in hip and knee arthroplasty. J Bone Joint Surg Am,2016,98(19):1646.
[15] Blumberg N,Kirkley SA,Heal JM. A cost analysis of autologous and allogeneic transfusions in hip-replacement surgery. Am J Surg,1996,171:324.
[16]Gilbody J,Dhotar HS,Perruccio AV,Davey JR. Topical tranexamic acid reduces transfusion rates in total hip and knee arthroplasty. J Arthroplasty,2014,29:681.